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Starting a Home and Mobile HIV Testing Service in a Rural Area of South Africa

Maheswaran, Hendramoorthy MBBS, MPH, MSc*,†; Thulare, Hilary MSc; Stanistreet, Debbi BA(Hons), MPH, PhD; Tanser, Frank PhD; Newell, Marie-Louise PhD†,§

JAIDS Journal of Acquired Immune Deficiency Syndromes: March 1st, 2012 - Volume 59 - Issue 3 - p e43–e46
doi: 10.1097/QAI.0b013e3182414ed7
Implementation and Operational Research: Epidemiology and Prevention

Objective: To compare users of a home and mobile HIV counseling and testing service implemented in rural KwaZulu-Natal, South Africa.

Methods: Communities of similar population size and density were allocated HIV counseling and testing provision be either home or mobile services. Uptake of services was compared, including results from a brief questionnaire.

Results: Majority of individuals proceeded to test. Mobile services reported a higher proportion of clients who were male (41% vs. 31%; P < 0.001), younger than 25 years (53% vs. 28%; P < 0.001), single (66% vs. 40%; P < 0.001), and never previously tested (62% vs. 56%; P = 0.003). Home services reported a higher proportion of clients older than of 35 years (56% vs. 35%; P < 0.001) and married/partner (43% vs. 30%; P < 0.001). HIV prevalence amongst clients of the 2 services was comparable, with both services testing more clients daily than the local primary health care clinics, but similar to the local hospital.

Conclusions: The numbers tested, different populations reached, and high detection rates suggest both modalities have an important role to play, especially in rural communities where cost of transport may be a deterrent.

*Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa

Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom

University of Liverpool, Liverpool, United Kingdom

§Centre for Paediatric Epidemiology and Biostatistics, University College London Institute of Child Health, London, United Kingdom.

Correspondence to: Hendramoorthy Maheswaran, MBBS, MPH, MSc, Africa Centre for Health and Population Studies, PO Box 198, Mtubatuba 3935, South Africa (e-mail:

The Hlabisa HIV Treatment and Care Program is made possible by the generous support of the American people through the United States Agency for International Development and the President's Emergency Plan (PEPFAR) under the terms of Award No 674-A-00-08-00001-00.

The opinions expressed herein are those of the authors and do not necessarily reflect the views of United States Agency for International Development or the United States Government.

The authors have no conflicts of interest to disclose.

Received June 14, 2011

Accepted November 9, 2011

© 2012 Lippincott Williams & Wilkins, Inc.